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胸腺瘤:治疗结果及放射治疗的作用

Thymoma: Results of treatment and role of radiotherapy.

作者信息

Hetnał Marcin, Małecki Krzysztof, Wolanin Magdalena, Korzeniowski Stanisław, Walasek Tomasz

机构信息

Radiation Oncology Department, Centre of Oncology, Krakow, Poland.

Brain, Head and Neck Cancer Unit, Centre of Oncology, Krakow, Poland.

出版信息

Rep Pract Oncol Radiother. 2010 Feb 18;15(1):15-20. doi: 10.1016/j.rpor.2010.01.004. eCollection 2010.

Abstract

PURPOSE

The aim of this study is to assess results of treatment, factors influencing prognosis with regard to causes of failure and treatment tolerance in patients with thymoma.

MATERIAL AND METHODS

Between 1966 and 2006, 63 patients with thymoma had been treated at the Centre of Oncology in Krakow. Patients were treated by means of different treatment modalities: surgery followed by radiotherapy (52%), radiotherapy alone (13%), chemoradiotherapy alone (15%), surgery followed by chemoradiotherapy (5%), surgery alone (5%) and others.

RESULTS

The 10-year locoregional recurrence-free survival (LRRFS) was 79%, disease free survival (DFS) was 57% and overall survival (OS) was 57%. Masaoka stage was the only independent prognostic factor for LRRFS. Masaoka stage and method of radiotherapy delivery (higher photon energies), were independent prognostic factors for OS. For DFS, the independent prognostic factors were age, type of treatment (favoured surgery followed by radiotherapy or chemoradiotherapy), Masaoka stage and year of start of treatment. Most common reactions were lung fibrosis in 36% of patients (mainly asymptomatic in most patients), pneumonitis (9%) and oesophagitis (4%).

CONCLUSIONS

Surgery combined with radiotherapy and chemoradiotherapy and modern radiotherapy techniques are correlated with improvement of survival in patients with early stage thymoma.

摘要

目的

本研究旨在评估胸腺瘤患者的治疗结果、影响预后的因素,包括失败原因和治疗耐受性。

材料与方法

1966年至2006年间,克拉科夫肿瘤中心共治疗了63例胸腺瘤患者。患者接受了不同的治疗方式:手术加放疗(52%)、单纯放疗(13%)、单纯放化疗(15%)、手术加放化疗(5%)、单纯手术(5%)及其他治疗。

结果

10年局部区域无复发生存率(LRRFS)为79%,无病生存率(DFS)为57%,总生存率(OS)为57%。Masaoka分期是LRRFS的唯一独立预后因素。Masaoka分期和放疗方式(较高光子能量)是OS的独立预后因素。对于DFS,独立预后因素为年龄、治疗类型(倾向于手术加放疗或放化疗)、Masaoka分期和治疗开始年份。最常见的反应是36%的患者出现肺纤维化(大多数患者主要无症状)、肺炎(9%)和食管炎(4%)。

结论

手术联合放疗、化疗以及现代放疗技术与早期胸腺瘤患者生存率的提高相关。

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